Archived: St Oswalds

• Is the service safe?

We found that the provider (Four Seasons) had taken appropriate action to ensure that important events that affect the welfare of people using the service are reported to the Care Quality Commission. This helps to safeguard the welfare of people using the service.

During our inspection we spoke with the regional manager, registered manager, six staff, five relatives and 13 people who used the service.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Policies and procedures had been developed by the registered provider (Four Seasons) to provide guidance for staff on how to safeguard the care and welfare of the people using the service.

The management team demonstrated awareness of the Mental Capacity Act and the circumstances when it was necessary to apply for authorisation to deprive a person of their liberty and to ensure the correct safeguards were in place.

The registered manager and staff spoken with demonstrated a good understanding of the different types of abuse, their duty of care to protect vulnerable adults and the action that should be taken in response to suspicion or evidence of abuse.

Records viewed confirmed that any safeguarding incidents were referred to the local authority's safeguarding unit in accordance with the organisation's policies and procedures.

Examination of recruitment records and discussion with staff confirmed the provider was operating a robust recruitment process. This helps to prevent unsuitable people from gaining employment with vulnerable people.

Upon reviewing records we noted that the provider had not always notified CQC of notifiable incidents and copies of some notifications were not available for reference. This is a requirement of the Care Quality Commission (Registration) Regulations 2009. A compliance action has been set in regard to this matter and the provider must tell us how they plan to improve.

Is the service effective?

People using the service were observed to be relaxed and at ease, clean and well-presented. Those who were able to discuss arrangements made for their care told us that they were happy and overall satisfied with the service.

The home employed an activities co-ordinator. Their job was to help plan and organise social and other events for people, either on an individual basis or in groups. People using the service confirmed they were asked what kinds of things they liked to do and there was a programme of activities available for people using the service to access.

On the day of our visit we observed a group of people reading newspapers with the activity coordinator discussing current affairs and issues of interest. People were seen to enjoy the activity session and the opportunity for meaningful and stimulating discussion.

Is the service caring?

People spoken with during our inspection confirmed the service was caring and responsive to their needs. Comments received from people using the service included: “It’s very good”; “It’s a nice place to live and I’ve made many friends”; “Staff are courteous”; “They look after you okay” and ”I think the standard of care I get is good. I have no complaints.”

Likewise, feedback received from relatives included: “We have been pleased with the service so far” and “It’s great. I’m happy with everything and have no concerns.”

Is the service responsive?

We looked at the personal files of three people who lived at St Oswald's during our inspection. We noted that the provider had developed a corporate care planning system that included an assessment of needs and a range of care plans which outlined: individual risks, needs, expected outcomes and care to be provided. Evaluation records had also been completed, to ensure information was reviewed on a regular basis.

A range of supporting documentation such as: background and social information; personal preferences; consent forms; health care records and other key documentation was also available to refer to. This helped to ensure that staff had the information they needed to respect the person's preferred wishes, likes and dislikes.

A four week rolling menu (which was reviewed periodically) had been produced in consultation with people living at St Oswalds. Menus viewed confirmed people using the service had access to a varied, balanced and wholesome diet. Refreshments were also served throughout the day and fresh fruit and snacks were available for people to eat.

Comments received from people using the service included: “I get plenty to eat and drink”; “Overall I’m happy with the catering but I think the menu could be improved”; “The meals are always pleasant” and “We get a choice of meal options”.

One relative spoken with highlighted there were occasional gaps in recording on a fluid intake / output chart. We raised this concern with the management team who assured us they would take action to address this concern.

Is the service well- led?

St Oswalds had a registered manager in place to provide direction and leadership to the staff team.

The registered provider had developed guidance on quality assurance for management and staff to refer to and a range of internal auditing systems had been established to enable the regional manager and the registered manager to maintain an overview of the service. For example, we saw audits for a range of areas including: nutrition; food safety; safeguarding; care documentation; medication; infection control; water temperature checks; management; human resources and health and safety.

Systems had been established to involve and obtain feedback from people using the service and / or their representatives. For example, the provider had distributed customer satisfaction surveys during October 2013 from the organisation's head office to people living at the service and their relatives. A summary report of the survey had been produced to illustrate the results and this was available for people to refer to.

Comments included: “The staff know you and know what you need”; “They [staff] always do their best for you”; “I’m very happy and I’m looked after well” and “It’s not a bad place to live and the care I get helps me to keep going”; “I can do as I wish. It’s our home isn’t it”; “I can do as I please” and “There are no routines except for meal times and these can be varied by arrangement.”

People living at the service told us that they were given choices with regard to daily living; activities; meals and reported that they could choose what to do, where to spend their time and who with. We received comments such as: “I can do as I wish. It’s our home isn’t it”; “I can do as I please” and “There are no routines except for meal times and these can be varied by arrangement.”

During our Short Observational Framework for Inspection (SOFI), we saw that staff members interacted in a positive and respectful manner towards the people they supported. Staff understood the need for gaining people's consent before assisting them with any type of support.